Americans Appalled over Drug Costs, Not Hopeful for Fix

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of health care.

Poll: Drug Costs Too High

A recent poll from the Kaiser Family Foundation found that 80 percent of Americans believe drug prices are too high, while only 39 percent have faith in the Trump Administration to fix it. According to the poll, lowering prescription drug prices was at the very top of the public's priority list, above infrastructure, solving the opioid epidemic, immigration reform, repealing the ACA or building a border wall.

The poll found that more than half of the public (52 percent) believe passing legislation to bring down drug prices should be a top priority for the administration, despite low expectations of seeing that come to fruition. Twenty-one percent of respondents reported they didn't trust either party to lower prices, up from 12 percent in 2016.

Furthermore, 72 percent of the respondents say pharmaceutical companies have "too much influence" in Washington, according to the poll. The poll also found that six in ten people (59 percent) are in favor of a national health plan, where Americans would receive insurance from a single government plan. Support for a national health plan rose to 75 percent when posed as an option among others for Americans to choose from.

EHR Data Predicts Future Opioid Use

Researchers at the University of Colorado Anschutz Medical Campus are developing prediction models to better forecast which patients will be prescribed opioid medications long term after being discharged from a health care facility. The researchers hope this information will help identify patients with higher risk of future opioid addiction.

In a study published in the Journal of General Internal Medicine, the researchers noted that while opioids are commonly prescribed for pain, little is known about which patients will receive chronic opioid therapy (COT) following discharge from a medical facility.

To develop the prediction model, the researchers used data from the EHR from Denver Health Medical Center, an urban hospital located in Denver, Colo. Researchers identified patient-specific variables which were associated with the progression to COT. Variables included having a history of substance use disorder, a recent receipt of a benzodiazepine, an opioid medication or a non-opioid analgesic, receipt of an opioid at hospital discharge, and high opioid requirements during hospitalization.

The model the researchers came up with correctly predicted chronic opioid therapy in 79 percent of the patients and no COT correctly in 78 percent of the patients. The prediction needs further evaluation before moving forward, according to the researchers.

EHR Data Identifies Undiagnosed Genetic Diseases

A new EHR data mining technique developed by researchers at Vanderbilt University Medical Center found that undiagnosed genetic diseases may be more prevalent in the general population than previously assumed.

Results of the study were published in the journal Science and reveal that patients diagnosed with heart failure, stroke, or infertility, among other conditions, could be suffering from undiagnosed genetic diseases.

To come up with the data mining technique, researchers mapped the clinical features of more than 1,200 Mendelian diseases into phenotypes captured from the EHR. They summarized this evidence as phenotype risk scores to find patterns of symptoms that may be caused by an underlying genetic variant, according to the study.

The developer of the technique, Josh Denny, MD, professor of biomedical informatics and medicine and director of the Center for Precision Medicine, says EHRs have a lot of unused data that can be helpful for diagnosis. "…we're using the fact that the electronic health record has a lot of diseases and phenotypes tracked in it, and we can mine those and assess them in a rapid way," Denny told Health Data Management.

"Interestingly, when I find myself in an unusually un-hectic day, I find it easier to continue that pace when I get home. We have developed a culture in which this type of [personal] space is a luxury, when in reality it is a necessity."